Toward an Understanding of Gender Differences in the Impact of Marital Conflict on Health

Spousal age difference and risk of hypertension in women: evidence from India

There has been steady progress in documenting the psychosocial risk factors of hypertension. However, most of the extant evidence is based on population from the developed countries. Using nationally representative data from India, this cross-sectional study explores whether spousal age gap is associated with risk of hypertension in married women aged 20 to 49 years. Based on the age difference with their husbands, women were grouped into four categories: husband was - i) of similar age, ii) 3-5 years older, iii) 6-9 years older, and iv) 10+ years older. Compared to women whose husbands were of similar age, the odds of having hypertension for the other categories were assessed by estimating multivariable logistic regression models. While the hypertension prevalence in our sample was 18.9%, it was 2.2%-points lower among women whose husbands were of similar age, and 3.3%-points higher among women whose husbands were 10+ years older. The adjusted odds of having hypertension for women with 10+ years of spousal age difference were 1.18 (95% CI: 1.13-1.24) times that of their counterparts who were of similar age to their husbands. These results were persistent in both younger (age 20-34) and older (age 35-49) women and robust across age at marriage, years in marriage, and various socioeconomic sub-groups including women's educational attainment, husband's educational level, household wealth, urban/rural residence, and geographic regions. The relationship also persisted after adjusting for husband's hypertension status. Our findings thus highlight spousal age difference as a biopsychosocial factor influencing the risk of hypertension in women.

Interpersonal relationships, PNI, and health: Seeds in the 1980s, fruiting trees today

In this contribution to the Special Issue, I highlight how Janice Kiecolt-Glaser's research in the 1980s planted the seeds for two areas of social relationships and health research: loneliness and intimate/marital relationships. I review the foundational "seed" studies from the mid-to late-1980s, the research "saplings" that sprouted and grew during the subsequent twenty years, and the "mature trees" that have gone on to fruit and grow their respective areas of inquiry over the past twenty years. In addition to highlighting the mature trees that have borne rich empirical fruit, my other goal for this contribution is to draw attention to ideas and concepts from Kiecolt-Glaser's work and writing that merit further conceptual and empirical examination in the next generation of research on social relationships, psychoneuroendocrinology, psychoneuroimmunology, and health.

A narrative review of mechanisms linking romantic relationship experiences to sleep quality

Although a significant body of research has revealed associations between romantic relationship experiences and sleep quality, there has not been clarity regarding the mechanisms underlying such associations. Toward this end, we review the existing studies that have tested mechanisms linking romantic relationship experiences to sleep quality. Guided by both theory and existing research, we organize our review around five key categories of mechanisms that may explain associations between romantic relationship experiences and sleep quality: emotional/affective responses, self-perceptions, social perceptions, self-regulation, and biological functioning. Our review of the literature indicates strong evidence in support of the mediating effects of emotional/affective mechanisms (e.g. emotions and mood states) in explaining associations between various aspects of romantic relationships (e.g. relationship satisfaction, partner conflicts, and attachment orientation) and sleep quality. Although there is ample theoretical support for the other mechanisms proposed, and although all proposed mechanisms have been separately linked to both romantic relationship experiences and sleep quality, few studies have directly tested them, pointing to profitable directions for future research. Understanding underlying mechanisms will enable the development of wise, process-based interventions that target specific mechanisms to improve couple members' sleep quality and romantic relationship functioning.

Partner's unemployment and subjective well-being: The mediating role of relationship functioning

Unemployment affects not only the subjective well-being of the individual, but also that of the partner. Based on the life course perspective and the spillover-crossover-model, we examine the mediating role of relationship functioning for such crossover effects of partner's unemployment on subjective well-being. We also test whether gender differences in the mechanism of relationship functioning can explain the larger overall crossover effects on women compared to men. We use data from the German Family Panel pairfam (2008/09-2018/19), which provide more direct and comprehensive measures of relationship functioning than previous research, and allow us to examine couples' communication and interactions, their conflict styles and behaviors, relationship satisfaction, and perceived relationship instability as mediators. To analyze the impact of the partner's transition to unemployment on subjective well-being, we use fixed effects panel regression models and the product method of mediation analysis to estimate the indirect effects of relationship functioning. The results show that a partner's transition to unemployment has a negative impact on one's own well-being. The effects are more pronounced for women than men which can be partly explained by gender-specific effects of the partner's unemployment on various aspects of relationship functioning, rather than by differential effects of the latter on one's own well-being.

Association between adverse childhood experiences and marital status among Japanese older adults

BACKGROUND

Marital status is a well-known social determinant of health. Adverse childhood experiences (ACEs) affect attachment, critical to establishing and maintaining intimate relationships, such as marital status.

OBJECTIVE

This study examined the association between ACEs and marital status among older Japanese adults.

PARTICIPANTS AND SETTING

This research used data from a nationwide population-based study among functionally independent people aged 65 and above in Japan.

METHODS

ACEs were assessed by self-reported questionnaires on the following experiences before 18 years old: parental death, parental divorce, parental mental disease, exposure to intimate partner violence, physical abuse, psychological neglect, psychological abuse, and poverty. Marital status was asked as currently having a spouse (including common-law marriage), widowed, divorced, or unmarried. Associations between the total number of ACEs and marital status were analyzed by multinomial logistic regression.

RESULTS

Three or more ACEs showed higher risks of being widowed, divorced, or unmarried. Psychological neglect led to higher divorce risks among males (RRR, 95%CI = 1.41, 1.13-1.76) and females (RRR, 95%CI = 1.56, 1.28-1.89). Childhood poverty showed higher risks of unmarried among males (RRR, 95%CI = 1.25, 1.02-1.53) and females (RRR, 95%CI = 1.41, 1.18-1.69). Association between ACEs and divorce risks showed gender differences (RRR, 95%CI of having three or more ACEs in males: 2.19, 1.66-2.90; in females: 3.45, 2.71-4.38; p for interaction = 0.034).

CONCLUSIONS

ACEs showed higher risks of being widowed, divorced, and unmarried among older Japanese people. Policy to tackle ACEs and research investigating how ACEs, attachment, and relationship quality influence marital status are required to promote well-being in later life.

The Role of Relationship Conflict for Momentary Loneliness and Affect in the Daily Lives of Older Couples

Background: Intimate partner relationships foster individuals' well-being throughout the lifespan. However, dissatisfying or conflict-laden relationships can have a detrimental impact on well-being and relationship quality. The majority of older adults live together with a spouse/partner, and intimate relationships are one of the most important social contexts in their daily lives. Purpose: Expanding on previous research, we examined the role of previous conflict on experiences of loneliness and affect in the daily lives of older partners from a dyadic perspective. Relationship duration and quality, personality traits (neuroticism and extraversion), conflict frequency during the measurement period, physical health as well as age were considered as moderators. Study Sample and Data Analysis: We used data from an experience sampling study with 151 older heterosexual couples (302 participants; 65+ years old) reporting on their positive and negative affect, loneliness, and previous experience of relationship conflict 6 times a day for 14 days. Data were analyzed using dyadic multilevel models. Results: For both men and women within couples, previous conflict was associated with an increased experience of negative affect and loneliness and a decreased experience of positive affect. Higher neuroticism predicted less positive and more negative affect following conflict for women and more loneliness for men. Higher relationship satisfaction predicted less increase in negative affect after conflict for female partners. Age, relationship duration, physical health, extraversion, and the number of conflict episodes showed no moderating effects. Conclusions: Our results support the notion that relationship conflict deteriorates emotional well-being in old age and renders older adults lonelier even in the context of intimate partner relationships.

Firefighter Relationship Satisfaction: Associations with Mental Health Outcomes

Firefighters demonstrate heightened rates of posttraumatic stress disorder, depression, anxiety, and alcohol consumption, compared to the general population. This study examined whether firefighters who were satisfied with their romantic relationships experienced lower severities of commonly reported mental health symptoms compared to firefighters who were dissatisfied with their relationships. The sample included 200 firefighters (97% male; M age =41.4, SD=9.3) currently married or living with a romantic partner who completed self-report measures via online survey. An established cut-off score of 13.5 (Couples Satisfaction Index-4) was used to define groups. Firefighters who indicated that they were dissatisfied reported higher levels of all measured outcomes.

Is it Better to Intermarry? Immigration Background of Married Couples and Suicide Risk Among Native-Born and Migrant Persons in Sweden

Marriage is protective against suicide across most populations, including for persons of different ethnicities and immigrant backgrounds. However, the well-being benefits of marriage are contingent upon marital characteristics-such as conflict and quality-that may vary across spousal dyads with different immigration backgrounds. Leveraging Swedish register data, we compare suicide mortality among married persons on the basis of their and their spouse's immigration backgrounds. We find that relative to those in a native Swede-Swede union, Swedish men married to female immigrants and immigrant women married to native men are at higher risk of death by suicide, while immigrants of both genders who are married to someone from their birth country have a lower risk of suicide mortality. The findings support hypotheses about the strains that may be encountered by those who intermarry, as well as the potential selection of individuals into inter- and intra-ethnic marriages.

Marital negativity's festering wounds: The emotional, immunological, and relational toll of couples' negative communication patterns

BACKGROUND

Dyadic stress theories and research suggest that couples' negative communication patterns threaten immune and emotional health, leaving partners vulnerable to illness. Spouses' relationship perceptions can also color how they see and react to marital discussions. To identify pathways linking distressed marriages to poor health, this study examined how self-reported typical communication patterns augmented discussion-based behavioral effects on spouses' blister wound healing, emotions, and discussion evaluations.

METHODS

Married couples completed two 24-hour in-person visits where they had their blood drawn to measure baseline interleukin-6 (IL-6), received suction blister wounds, reported their typical communication patterns (demand/withdraw strategies, mutual discussion avoidance, mutual constructive communication), and engaged in marital discussions. Discussions were recorded and coded for positive and negative behaviors using the Rapid Marital Interaction Coding System (RMICS). Immediately after the discussions, spouses rated their emotions and evaluated the discussion tone and outcome. Wound healing was measured for 12 days.

RESULTS

Couples who reported typically using more demand/withdraw or mutual avoidance patterns had higher baseline IL-6, slower wound healing, greater negative emotion, lower positive emotion, and poorer discussion evaluations. In contrast, couples reporting more mutual constructive patterns reported more favorable discussion evaluations. Additionally, couples' more negative and less positive patterns exacerbated behavioral effects: Spouses had wounds that healed more slowly, reported lower positive emotion, and evaluated the discussions less positively if their typical patterns and discussion-based behaviors were more negative and less positive.

CONCLUSIONS

Couples' typical communication patterns-including how often they use demand/withdraw, mutual avoidance, and mutual constructive patterns-may color spouses' reactions to marital discussions, amplifying the biological, emotional, and relational impact. These findings help explain how distressed marriages take a toll on spouses' health.

The role of marriage in the life satisfaction and mortality association at older ages: age and sex differences

OBJECTIVES

Although life satisfaction (LS) could reduce mortality risk of older adults, whether the LS-mortality link is consistent in older adults with different marital status is largely unknown. In this study, we examine (1) how the LS-mortality association at older ages varies by marital status and marital quality, and (2) whether the role of marriage in the LS-mortality link differs between young-old (ages 65-79) and oldest-old (ages 80+) ages and between men and women in mainland China.

METHODS

We used five waves of data from a nationally representative survey in mainland China and applied the multilevel random effect of survival analysis to examine the LS-mortality association in Chinese older adults by marital status, controlling for a wide set of covariates.

RESULTS

First, the protective effect of LS on mortality was valid in older men regardless of their marital status, whereas the protective effect was only valid in currently-not-married older women. Second, for a good marriage, LS significantly reduced mortality risk irrespective of gender and age, while for a poor marriage, LS had no significant association with mortality of older adults. Third, the LS-mortality association seemed to be stronger in the oldest-old than in the young-old irrespective of their marital status.

CONCLUSION

Given the pivotal role of spouse in daily life, the society should create an age-friendly social environment for re-marriage among older adults who wish to get re-married, while highlighting and advocating the importance of good marriage in determining healthy aging, and design various policies to improve the LS of older people to reduce their mortality risk.

Supplemental data for this article is available online at.

"We've Got This": Middle-Aged and Older Couples' Satisfying Relationships and We-Talk Promote Better Physiological, Relational, and Emotional Responses to Conflict

OBJECTIVE

Conflict poses multiple relational and health risks. Dyadic stress theories suggest satisfaction and communication alter cardiovascular and autonomic function, key pathways from troubled relationships to poor health. However, "we-talk," a positive communication pattern, can strengthen relationships and promote health. We examined how each spouse's satisfaction and we-talk were related to conflict's physiological, relational, and emotional toll.

METHODS

Married couples ( n = 107 couples, 214 individuals, ages 40-87 years) who were mostly White, highly educated, and higher-income Americans in different-gender relationships engaged in 20-minute conflict discussions while wearing monitors to assess heart rate variability (HRV). Spouses rated their closeness immediately after conflict and their conflict rumination 2 hours later. Conflict transcriptions measured we-talk, or the proportion of first-person plural pronouns (we, us, our).

RESULTS

Satisfied spouses or those in mutually satisfying relationships had higher HRV during conflict ( b = 0.0001, p = .049), felt closer immediately after conflict ( b = 0.07, p < .001), and ruminated less about the conflict 2 hours later ( b = -0.26, p = .026). Spouses' HRV was highest ( b = 0.0002, p = .002) and rumination was lowest ( b = -0.49, p = .019) when they or their partners were satisfied and used we-talk more often. Women's HRV ( b = 0.0001, p = .035) and rumination ( b = -0.01, p = .02) benefited when both spouses were satisfied, as did closeness when women were satisfied ( b = 0.10, p < .001). Men's closeness benefited when they ( b = 0.04, p = .003) or their wives ( b = 0.04, p = .002) were satisfied.

CONCLUSIONS

The combination of mutually satisfying relationships and we-talk was associated with better relational and health outcomes after conflict. These findings are important for middle-aged and older couples whose relationships are central to their health.

Sexual Violence in Military Service Members/Veterans Individual and Interpersonal Outcomes Associated with Single and Multiple Exposures to Civilian and Military Sexual Violence

Sexual harassment and violence is a grave public health concern and risk for revictimization increases following initial exposure. Studies of sexual revictimization in military samples are generally limited to women and are focused on rates of posttraumatic stress disorder (PTSD), with no examination of how revictimization relates to interpersonal outcomes, such as relationship or sexual satisfaction. The current study addressed these gaps in a sample of 833 women and 556 men service members/veterans. Self-reported outcomes of PTSD, depression, suicidal ideation, sexual function, and relationship satisfaction were compared across those reporting exposure to sexual harassment and violence before the military only (i.e., pre-military), during the military only (i.e., military sexual harassment and violence [MSV]), before and during the military (i.e., revictimization), and to no exposure. More than half of women (51.14%, n = 426) reported revictimization and only 5.79% (n = 28) of men reported revictimization. Among women, those reporting MSV or revictimization tended to report higher PTSD, depression, and suicidal ideation relative to pre-military sexual violence and no sexual violence exposure. No interpersonal outcomes were significantly different among these sexual violence groups. Among men, revictimization was associated with higher PTSD, depression, and sexual compulsivity. PTSD and depression were also higher among those reporting MSV only. No effects were found for premilitary sexual trauma exposure only or relationship satisfaction for either group. Findings highlight the particularly bothersome nature of MSV, whether it occurred alone or in tandem with premilitary sexual violence. Findings also show unique gender differences across outcomes, suggesting interventions following sexual harassment and violence may differ for men and women.

How aging couples' emotional and physiological associations change across positive, supportive, and conflictual discussions: Roles of capitalization and responsive behaviors

BACKGROUND

Couples' emotions and physiology change across interactions and based on behaviors. Aging couples' emotions and physiology may be closely related as they spend more time together and rely on each other for support. We examined aging couples' emotional and physiological associations across multiple indices and marital interactions; we also assessed how couples' capitalization and responsive behaviors during the first discussion were protective in subsequent emotional conversations.

METHODS

Married couples (n = 107 couples, 214 individuals) engaged in positive event, social support, and conflict discussions. Emotional and physiological assessments across discussions included: positive and negative emotion, electrodermal activity, systolic and diastolic blood pressure, heart rate, and heart rate variability. We coded partners' capitalization and responsive behaviors during the first discussion.

RESULTS

There were ties in spouses' positive emotion, negative emotion, electrodermal activity, systolic blood pressure, heart rate, and heart rate variability during positive, supportive, and conflictual discussions. Emotional and physiological associations reflecting shared stress (negative emotion, electrodermal activity, systolic blood pressure) were stronger in couples who were less capitalizing or responsive earlier that day; associations reflecting physiological adaptation (heart rate variability) were stronger for more capitalizing and responsive couples.

CONCLUSION

Aging couples' emotions and physiology tracked together during discussions central to maintaining relationships, and their past behaviors carried over into future interactions and across contexts. Enthusiastic, caring, and understanding behaviors may protect partners from shared emotional and physiological stress; lacking such behaviors may increase emotional and physiological vulnerability. This research identifies behavioral, emotional, and physiological pathways connecting relationships to health in adulthood.

Association between Experiences in Life and Quality of Life among Lebanese University Students in a Collapsing Country: The Moderating Role of Religious Coping and Positivity

(1) Background: No goal can be more important than optimal individual quality of life (QOL); life experiences, religious coping, and positivity play pivotal roles in achieving this goal. The aim is to assess the correlation between positive/negative experiences in life and QOL, taking into consideration the moderating role of positivity and positive/negative religious coping among a sample of Lebanese university students. (2) Methods: This cross-sectional study was carried out between November and December 2021, and enrolled 333 university students, aged between 18 and 30 years, from various areas in Lebanon’s governorates. The 12-item Short Form Health Survey, the brief religious coping methods scale, and the Scale of Positive and Negative Experience were included in the questionnaire. Forward linear regressions were conducted to check for correlates associated with physical and mental QOL scores. All variables that showed a correlation or effect size > |0.24| were entered in the multivariable and moderation models as independent ones. Significance was set at a p < 0.05. (3) Results: A linear regression, taking the physical QOL score as the dependent variable, showed that living in rural areas compared to urban and more positivity were significantly associated with a better physical QOL, whereas more negative religious coping was significantly associated with a lower physical QOL. More positivity and more positive religious coping were significantly associated with a better mental QOL. The moderation analysis showed that in people with high positive experiences, those with higher negative religious coping had lower mental QOL. (4) Conclusions: In a society as deeply religious as Lebanon, it is crucial to organize awareness programs to help in discriminating between religious coping mechanisms. Across order to stop further detrimental effects on QOL, our findings may serve as a solid foundation for future studies of QOL with additional variables, in other groups and nations.

Midlife financial strain and later-life health and wellbeing of husbands and wives: Linking and moderating roles of couple intimacy trajectories

This study investigates (a) heterogeneous trajectories of couple intimacy over the mid-later years (average ages of 40-65) and (b) how these intimacy classes are differentially associated with spouses' midlife financial strain as well as their later-life health and wellbeing outcomes. The sample was comprised of white couples in long-term marriages from the rural Mid-west who experienced the economic downturn of the farm crisis in late 1980s. Couple-level measures of emotional intimacy and sexual intimacy were created by summing husbands' and wives' reports. Using growth mixture modeling with a sample of 304 couples, conjoint intimacy classes were identified from trajectories of couple emotional intimacy and sexual intimacy. Three qualitatively different latent intimacy classes of couples were identified: Consistently High, Moderate and Increasing, and Chronically Low. Intimacy classes were differentially associated with midlife financial strain and later-life health and wellbeing. Spouses with consistently high and moderate and increasing intimacy in their mid-later years averaged lower financial strain in early midlife and better health and wellbeing outcomes in later years (>67 years) compared to those with consistently low intimacy after controlling for lagged health measures. The identification of couple intimacy trajectory groups provides a potentially useful prognostic tool for counseling efforts that can promote and develop resiliency factors to aid in the redirection of adverse couple intimacy trajectories.

Conjoint trajectories of couples' marital and parental conflictual behaviors and later-life mental, physical, and relational health

Conflictual marital and parental relationships mutually reinforce each other generating family-level stress. The cumulative experiences of stressful family conflictual circumstances (a family-level construct of family conflictual circumstances (FCC), based on marital and parental conflictual behaviors) affect a couple's well-being. The present study, utilizing longitudinal data of 370 couples in enduring marriages and a person-centered approach, examined: a) the existence of heterogeneous groups of couples with FCC trajectory patterns, b) whether individual and contextual factors are associated with FCC trajectory patterns, and c) differential later-life health and relational consequences of these groups. We identified four heterogeneous groups of couples with distinct FCC trajectory patterns in the early middle years (from 1990 to 1994; approximately age 40 for both husbands and wives). Personal (neurotic vulnerability) and contextual factors (family financial hardship) influenced the development of the FCC trajectories, and FCC trajectory patterns were consequential for spouses' later mental, physical, and relational health (2001). Two features of the longitudinal synchrony in FCC trajectory patterns (severity and synchrony) were utilized to explain the differential impacts of the trajectory patterns on spouses' later health and relational outcomes.

Perceived Discrimination and Relationship Satisfaction Among Same-Sex Couples: The Role of Dyadic Stress and Sex

Based on the fact that most research drawn from the minority stress theory on the association between minority stress and relationship satisfaction has focused on an individual perspective rather than a dyadic perspective, and the limited evidence of the systemic transactional model (STM) explore the topics of same-sex couples. This study aims to combine both theories to examine the association between perceived discrimination and relationship satisfaction among lesbian, gay, and bisexual (LGB) people on both partners and test the potential mediating role of dyadic stress and sex difference in this association. Using an actor-partner interdependence mediation model (APIMeM), we analyzed data including a sample of 241 LGB couples (133 female and 108 male same-sex dyads). Results showed that perceived discrimination had no direct actor-partner effects on relationship satisfaction. APIMeM revealed significant indirect partner effects from perceived discrimination on both individuals' and their partners' relationship satisfaction through the partner's dyadic stress. Additionally, the effect of personal dyadic stress on a partner's relationship satisfaction was stronger for women compared to men. These findings demonstrated the utility of the minority stress theory and STM framework for understanding the risk of stressors in damaging LGBs' romantic relationships. Couple interventions should integrate knowledge from a dyadic perspective with attention to sex differences.

Empty Nest Status, Marital Closeness, and Perceived Health: Testing Couples' Direct and Moderated Associations with an Actor-Partner Interdependence Model

Building on previous examinations of marital outcomes in the empty nest phase that have been based on surveys of individuals (primarily wives), the current study examined the direct effect of no longer living with children in the home (versus continuing to live with children) on husbands and wives' ratings of marital closeness as well as their perceived health. The study also tested whether couples' empty nest status moderated the associations between spouses' marital closeness and health. Analyses were based on 3,765 mixed-sex couples drawn from the Wisconsin Longitudinal Study. Dyadic multilevel modeling and actor-partner interdependence models (APIM) were used to test hypotheses. Results indicated that, accounting for known covariates, being in the empty nest was directly linked with both husbands and wives reporting higher levels of marital closeness and with wives (only) reporting better health. Moderating findings were less consistent, with the single reliable moderation result indicating that wives' perceived health was improved at higher levels of their husbands' marital closeness only among couples who were still living with children in the home. Clinical implications and future research directions are discussed.

Depressive Symptoms, External Stress, and Marital Adjustment: The Buffering Effect of Partner's Responsive Behavior

Guided by theory emphasizing that partner responsiveness underlies well-functioning romantic relationships, we examined whether partners' responsive behavior buffered the degree to which a personal vulnerability (depressive symptoms) and external stress predicted declines in relationship adjustment. Using an existing dataset, we tested whether individuals' depressive symptoms and stress interacted with observer-coded partner responsive behavior during marital conflict discussions to predict change in marital adjustment at the next time point (N = 195 couples Time 1 to Time 2, 158 couples Time 2 to Time 3). Individuals experiencing greater (a) depressive symptoms or (b) stress showed sharper declines in marital adjustment. However, as predicted, the negative effects of both depressive symptoms and stress were attenuated when partners displayed high behavioral responsiveness. These findings underscore the importance of adopting a dyadic perspective to understand how partners' responsive behavior can overcome the harmful effects of personal and situational vulnerabilities on relationship outcomes.

Marital Strain and Support and Subjective Well-Being in Later Life: Ascribing a Role to Childhood Adversity

Objectives: We integrate the life course perspective with the stress-process model to offer a framework for how childhood conditions moderate the relationship between marital support/strain and subjective well-being in older adulthood for men and women. Methods: Drawing on longitudinal data from the National Social Life, Health, and Aging Project (NSHAP), we use a series of lagged dependent-variable models and stratify the sample by gender. Results: Our results suggest that the benefits associated with greater marital support are stronger for those that did not live with both parents in childhood for men. Women raised in families that experienced financial hardship reported lower subjective well-being in the context of marital strain. Conclusion: Adverse experiences in childhood can be scarring or foster resilience related to well-being in the context of strained or supportive marriages.

Harmonious Relations: Relational Interdependence Moderates Affective Reactivity to Interpersonal Stressors

Negative social interactions have been linked to worse psychological health. However, individuals’ perceptions of negative interactions may depend on relational interdependent self-construal or how much they define the self in terms of their close relationships. The current analysis examined whether the effect of three different stressors on daily mood is moderated by having a relational self-construal. Participants ( N = 833) from a national, community-based study reported relational self-construal, the experience of three types of stressors, negative affect, and positive affect on 8 consecutive days. Compared to less relationally interdependent individuals, more relationally interdependent individuals experienced a greater increase in negative affect from the prior day when an interpersonal conflict occurred but a lesser increase in negative affect from the prior day when an interpersonal conflict was avoided. These results suggest that the type of interpersonal stressor determines whether self-construal is a risk factor or protective factor for psychological health.

The Link Between Major Life Events and Quality of Life: The Role of Compassionate Abilities

This study examined whether compassionate skills (the ability to be self-compassionate and to receive compassion from others) operate as mediator processes in the relationship between negative major life events and psychological quality of life (QoL), in 467 adults. The path model accounted for 48% of psychological QoL' variance and indicated that negative appraisal of major life events was associated with decreased psychological QoL, through increased levels of shame and less compassionate abilities. Findings support the importance of community programmes to enhance psychological QoL, that help individuals cultivate self-compassion and the ability to receive compassion from others, especially in face of adverse events.

Marital Quality and Well-Being Among Older Adults: A Typology of Supportive, Aversive, Indifferent, and Ambivalent Marriages

A large body of work has linked marital quality to the health and well-being of older adults, but there is a lack of agreement on how to best measure dimensions of marital quality. Drawing on a stress-process life course perspective, we construct a typology of marriage type that captures the synergistic relationship between positive and negative marital qualities and health. Using data from Wave 1 (2005/2006) and Wave 2 (2010/2011) of the NSHAP survey from the United States, we examine the association between supportive, aversive, ambivalent, and indifferent marriages for older adults that remained married over the study period on multiple indicators of well-being (depression, happiness, and self-rated health; N = 769 males and 461 females). Results suggest that older adults in aversive marriages reported lower happiness (men and women) and physical health (men). There was less evidence that those in ambivalent and indifferent marriages reported worse well-being.

The development of gendered health-related support dynamics over the course of a marriage

For married adults with chronic illnesses or functional limitations, informal support from a spouse is often essential for their well-being, but support around health issues is not confined to later life. Attention to processes of support throughout the entire intimate relationship can provide insight into support dynamics in later life. Additionally, health-related support from a spouse tends to be gendered with women providing more support. Our analysis of relationship timeline interviews with 23 older adult couples demonstrates that these gendered support dynamics develop and are sustained throughout a marriage. We identify three patterns of support: (1) acknowledged gender inequality in support in which women readily provided support when their husbands had health issues but men provided support less consistently for their wives' health issues throughout the relationship; (2) mutual support in which both spouses provided support for the other whenever there were health needs; and (3) independence, in which men and women provided relatively little support to one another, viewing each other as responsible for their own health and well-being. These support patterns are established early within marriages and continue as health issues intensify. These patterns of spousal support are linked to broader systems of gender inequality and societal messages about gender. Our study moves away from conceptualizations of support provisions around health issues as only being situated in later life. We instead show how dynamics of support are developed and normalized throughout a marriage and suggest that spousal support studies should take into account long-term marital dynamics.

Self-perceptions of aging and domain-specific health outcomes among midlife and later-life couples

Objectives: This study places the self-perceptions of aging (SPA)-health link in the couple context and examines how changes in one’s own and spouse’s SPA influence multiple health domains and how such associations differ by gender. Methods: Fixed-effects regression models were estimated. Data were drawn from the Health and Retirement Survey ( N = 5972). Results: For both husbands and wives, almost all health domains declined when their own SPA became more negative. The spouse’s SPA were associated with one’s self-rated health, regardless of gender. Gender differences existed in some cross-spousal health effects; while the husband’s SPA were associated with his wife’s depressive symptoms, the wife’s SPA were associated with her husband’s physical disability, functional limitations, and chronic diseases. Discussion: The SPA–health association extends beyond the individual in married persons, demonstrating intertwined health trajectories in older couples. The detrimental effects of ageism might be underestimated if the spillover effects were not considered.

Marital Power and Depressive Symptoms among Older Mexican Adults

An extensive body of research documents marital status differences in health among older adults. However, few studies have investigated the heterogeneity in depressive symptomatology among older married adults living in developing countries. Our study investigates the interplay of gender and marital power dynamics for mental health among older Mexican adults. Our sample includes older married couples in the 2015 Wave of the Mexican Health and Aging Study (n=3,621 dyads). We use seemingly unrelated regression to model the association between self-reported distributions of decision-making power within marriages and depressive symptoms for husbands and wives. For approximately 41 per cent of couples, the husband and wife both reported an equal distribution of power in the marriage. Compared to those who reported an equal power distribution, husbands and wives who reported an imbalance of power (having more power or less power than their spouse) reported more depressive symptoms. Levels of depressive symptoms were higher in marriages characterised by an unequal balance of power. The relationship between equality in power and depressive symptoms is not explained by health care needs or living arrangements. Marital quality is an important factor for understanding depressive symptoms among older Mexican adults.

MARITAL STRAIN AND PSYCHOLOGICAL DISTRESS IN SAME-SEX AND DIFFERENT-SEX COUPLES

OBJECTIVE

This study examines the association of marital strain - as reported by each spouse - with psychological distress and considers whether the associations vary for men and women in gay, lesbian, and heterosexual marriages.

BACKGROUND

Prior studies show that marital strain is associated with psychological distress. However, most studies rely on only one spouse's perspective and do not consider how appraisals of strain from both spouses may contribute to distress. Moreover, possible gender differences in these associations have been considered only for heterosexual couples.

METHOD

Analyses are based on 10 days of dyadic diary data from 756 midlife U.S. men and women in 378 gay, lesbian, and heterosexual marriages. Multilevel modeling is used to examine the association of self- and spouse-reported marital strain with psychological distress; actor-partner interdependence models (APIM) explore possible gender differences in these associations.

RESULTS

Both self- and spousal-reports of marital strain are associated with psychological distress, with notable gender differences. The associations of self- and spouse-reported marital strain with distress are stronger for women in different-sex marriages when compared to men in same-sex and different-sex marriages. The association is also stronger for women in different-sex marriages compared to women in same-sex marriages, but for self-reported strain only.

CONCLUSION

Marital appraisals by both spouses are important for psychological well-being and may be especially important for the well-being of women in different-sex marriages.

Marital functioning and treatment outcome in couples undergoing assisted reproduction

AIM

To investigate the relationship between the quality of marital functioning and communication, individual psychological symptomatology, and pregnancy achievement in couples undergoing assisted reproduction.

BACKGROUND

The results concerning marital functioning and the feasibility of pregnancy yield contradictory outcomes and the quality of the relationship of the couple undergoing assisted reproduction has not been analysed from systemic models. Our hypothesis is that when undergoing assisted reproduction treatment (ART), the couple's functioning and communication will be related to the pregnancy rate.

DESIGN

This study employs a cross-sectional design with couples receiving ART.

METHODS

Spanish heterosexual couples (N = 185) completed the self-report instruments. The data were collected from 2010 - 2015. All the couples completed at least one treatment process, or at least 1 year had gone by since beginning the treatment.

RESULTS

The association between couple relationship quality and the individual psychological symptomatology experienced during the assisted reproduction process was confirmed in men and women. Although both members of the couple experienced an increase of symptomatology, only men's symptomatology was statistically significantly linked to pregnancy achievement.

CONCLUSION

It is necessary to support the couple from the assisted reproduction centres, promoting cohesion, flexibility, and communication in the relationship. The intervention process should also be understood from a systemic perspective; that is, considering dyadic transactions as a systemic unit. Two aspects seem to be especially relevant for clinical nurses in ART: (a) the man's role is crucial for treatment success; (b) the woman's communication is crucial to the process.

Self-perceived coping resources of middle-aged and older adults - results of a large population-based study

OBJECTIVES

Psychosocial resources (personal resources, social resources, and other) are important for coping with aging and impairment. The aim of this study was to describe the resources of older adults and to compare subgroups with frailty, complex health care needs, and/or mental disorders.

METHOD

At the third follow-up of the large population-based German ESTHER study, 3124 elderly persons (aged 55-85) were included. Psychosocial resources were assessed during a home visit by trained study doctors by using a list of 26 different items. Resources were described for the total group, separated by sex, and for the three subgroups of persons with frailty, complex health care needs, and mental disorders.

RESULTS

Family, self-efficacy, and financial security were the most frequently reported resources of older adults. Women and men showed significant differences in their self-perceived resources. Personal resources (self-efficacy, optimism, mastery), social resources, and financial security were reported significantly less frequently by frail persons, persons with complex health care needs, and mentally ill older adults compared to non-impaired participants. Apart from external support, patients who experienced complex health care needs reported resources less frequently compared to frail and mentally ill patients.

CONCLUSION

Coping resources in older adults are associated with sex and impairment. Evaluation and support of personal resources of frail or mentally ill persons or individuals with complex health care needs should be integrated in the therapeutic process.

The impact of life events on adult physical and mental health and well-being: longitudinal analysis using the GoWell health and well-being survey

Background

It is recognised that life events (LEs) which have been defined as incidents necessitating adjustment to habitual life either permanently or temporarily, not only have the potential to be detrimental to health and well-being, but research suggests some LEs may be beneficial. This study aimed to determine the individual and cumulative occurrence of LEs; and to establish their effect on health and well-being.

Results

Demographic factors (gender, age and highest educational attainment), LE occurrence and self-reported health data were collected as part of the longitudinal GoWell community health and wellbeing survey (2008–2011). Self-reported health was measured using the SF-12 questionnaire for physical (SF-12 PCS) and mental health (SF-12 MCS) and the Warwick–Edinburgh mental well-being scale (WEMWBS) for well-being. Statistical analysis was performed using SPSSv21 and level of significance was set at p < 0.05. Results showed that the sample was 61.6 % (n = 768) female; 20.4 % (n = 254) were aged 16–39 years, 46.1 % (n = 575) 40–64 years and 33.5 % (n = 418) were over 65 years; 68.8 % (n = 819) had no qualifications/Scottish leaving certificates, with the remaining 31.2 % (n = 372) having their highest educational qualification above Scottish leaving certificates. Health score means were 49.3 SF-12 mental health component score (SF-12 MCS); 42.1 SF-12 physical health component score (SF-12 PCS); and 49.2 WEMWBS. Participants experienced 0–7 LEs over a three year period, with the most common being: housing improvement (44.9 %), house move (36.8 %), health event (26.3 %) and bereavement (25.0 %). Overall, an increase in LEs was associated with a health score decrease. Five LEs (relationship breakdown, health event, bereavement, victimisation and house move) had negative impacts on SF-12 MCS and two (new job/promotion and parenthood) had positive impacts. For SF-12 PCS only three (health event, bereavement and housing improvement) had a negative impact. Six (health event, victimisation, bereavement, relationship breakdown housing move and improvement) had negative impacts on well-being and two (new job/promotion, marriage) had positive effects.

Conclusions

Findings from the current study confirm LEs have both detrimental and beneficial impacts on health and well-being. Further research is required to disentangle the complexity of LEs and the ways they affect health and well-being.

Hey Mr. Sandman: dyadic effects of anxiety, depressive symptoms and sleep among married couples

This study examined associations among anxiety, depressive symptoms, and sleep duration in a sample of middle-aged couples using the actor-partner interaction model with dyadic data. Self-report measures were completed independently by both partners as part of the health histories obtained during their annual preventive medical examinations in 2011 and 2012. Results showed that husbands' anxiety and depressive symptoms had a stronger effect on their wives' anxiety and depression than the other way around, but this was not moderated by one's own sleep duration. For both wives and husbands, higher levels of depressive symptoms and anxiety predicted shorter sleep duration for their partner 1 year later, although the effect of husbands' mental health on their wives' was again stronger. The findings suggest that sleep problems might better be treated as a couple-level phenomenon than an individual one, particularly for women.

Depression during pregnancy and the postpartum among HIV-infected women on antiretroviral therapy in Uganda

Supplemental Digital Content is Available in the Text.

Background:

Among HIV-infected women, perinatal depression compromises clinical, maternal, and child health outcomes. Antiretroviral therapy (ART) is associated with lower depression symptom severity but the uniformity of effect through pregnancy and postpartum periods is unknown.

Methods:

We analyzed prospective data from 447 HIV-infected women (18–49 years) initiating ART in rural Uganda (2005–2012). Participants completed blood work and comprehensive questionnaires quarterly. Pregnancy status was assessed by self-report. Analysis time periods were defined as currently pregnant, postpartum (0–12 months post-pregnancy outcome), or non–pregnancy-related. Depression symptom severity was measured using a modified Hopkins Symptom Checklist 15, with scores ranging from 1 to 4. Probable depression was defined as >1.75. Linear regression with generalized estimating equations was used to compare mean depression scores over the 3 periods.

Results:

At enrollment, median age was 32 years (interquartile range: 27–37), median CD4 count was 160 cells per cubic millimeter (interquartile range: 95–245), and mean depression score was 1.75 (s = 0.58) (39% with probable depression). Over 4.1 median years of follow-up, 104 women experienced 151 pregnancies. Mean depression scores did not differ across the time periods (P = 0.75). Multivariable models yielded similar findings. Increasing time on ART, viral suppression, better physical health, and “never married” were independently associated with lower mean depression scores. Findings were consistent when assessing probable depression.

Conclusions:

Although the lack of association between depression and perinatal periods is reassuring, high depression prevalence at treatment initiation and continued incidence across pregnancy and non–pregnancy-related periods of follow-up highlight the critical need for mental health services for HIV-infected women to optimize both maternal and perinatal health.

Marital quality and health: Implications for marriage in the 21st century

Being in a happy marriage is related to better psychological and physical health. This paper describes current approaches to conceptualizing and measuring marital quality and physical health, and results from a recent meta-analysis examining associations between marital quality and physical health outcomes. To illustrate the practical significance of these findings, this paper also illustrates how the magnitude of the marital quality - physical health association is similar in size to associations between health behaviors (diet, physical activity) and health outcomes, and briefly reviews the state of the science regarding plausible biobehavioral pathways that explain how marital functioning influences health. After describing the current state of research on factors that might modify the association between marital quality and health, particularly individual differences and gender, the paper concludes with implications of the past 50 years of research on marital quality and health for marriage in the 21^st century.

I do…do you? Dependence and biological sex moderate daters' cortisol responses when accommodating a partner's thoughts about marriage

We examined how daters' levels of relationship dependence interact with men's and women's degree of accommodation during a likelihood of marriage discussion to predict cortisol levels at the conclusion of the discussion. Upon arriving at the laboratory, couple members were separated and asked to graph their perceived likelihood of one day marrying each other. Couples were reunited and instructed to create a joint graph depicting their agreed-upon chance of marriage. For the majority of couples, negotiating their likelihood of marriage required one or both partners to accommodate each other's presumed likelihood of marriage. Multilevel analyses revealed a significant Dependence×Accommodation×Sex interaction. For women who increased their likelihood of marriage, feelings of dependence predicted heightened levels of cortisol relative to baseline; we suggest such a response is indicative of eustress. Among men, those who accommodated by decreasing their likelihood of marriage experienced significantly lower levels of cortisol to the extent that they were less dependent on their partners. Discussion focuses on why men and women show different physiological reactions in response to seemingly favorable outcomes from a relationship discussion.